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HomeMy WebLinkAbout618638 EVERLAST CLIMBING INDUSTRIES INC - INSURANCE CERTIFICATE (4)i 1 ® A` o0Rn CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 07/31/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Marsh USA, Inc. Two Alliance Center CONTACT NAME: PHONE FAX A/C No): E-MAIL ADDRESS: 3560 Lenox Road, Suite 2400 Atlanta, GA 30326 Attn: Atlanta.CertRequest@marsh.com / Fax: 212-9484321 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Westchester Fire Insurance Company 10030 CN102326389-CTS-GAUWX-18-19 INSURED Evedast Climbing Industries, Inc. dba Colorado Time Systems, Inc. INSURER B : Travelers Property Casualty Company Of America 25674 INSURER C : National Union Fire Insurance Co. of Pittsburgh, PA 19445 INSURER D : Phoenix Insurance Company 25623 1551 E.11th St. Loveland, CO 80537 INSURER E : Liberty Surplus Insurance Corp10725 INSURER F : COVERAGES CERTIFICATE NUMBER: ATL-004365418-19 REVISION NUMBER: 3 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTRWVD TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MMIDDOL'C YYY MM DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY G2821800A 002 08/01/2018 08/01/2019 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE � OCCUR RENTED A AGE ToEa occurrence PREMISES $ 100,000 X SIR $10,000 Per Occ. MED EXP (Any one person) $ EXCLUDED PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY JECOT- LOC PRODUCTS - COMP/OP AGG $ 4,000,000 POLICY AGGREGATE $ 10,000,000 OTHER: B AUTOMOBILELIABIUTY TJ-CAP-9D897065TIL-18 08/01/2018 08/01/2019 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ ComplColl Ded: $1,000 $ X UMBRELLA LIAB lOCCUR BE 014788208 08/01/2018 08/01/2019 EACH OCCURRENCE $ 25,000,000 AGGREGATE $ 25,000,000 EXCESS LIAB CLAIMS -MADE DED I X I RETENTION $ lO 000 $ B D B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N!A TROUB-9D90032-6-18 TC2NUB-9D90031-4-18 UB-7J602089-18-14-G 08/01/2018 08101/2018 /01/2019 08/0112019 08/01/2019 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below (See Additional Page.) E Excess Umbrella 1000064456-08 08/01/2018 08/01/2019 Each Occurrence 25,000,000 E: Aggregate 25,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Re: RFP 8107 - Athletic Field Scoreboards City of Fort Collins is listed as additional insured as their interests may appear, during and until completion of the project, on a primary and non-contributory basis via CG 2010 & CG 2037 , as required by written contract. A Waiver of Subrogation applies in favor of the additional insureds on the Workers Compensation policy, where required by written contract. CFRTIFICATF HOI nFR CANCELLATION City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PO Box 580 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Fort Collins, CO 80522 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi MukherjeeAuars mil u te_wae l ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD